Tag: insurance

The Obamacare secret at the heart of the shutdown: insurers made billions at taxpayer expense

The 42-day federal shutdown forced by Democrats thrust the economics of Obamacare into the limelight, and exposed an uncomfortable truth: An insurance industry whose executives are increasingly liberal donors has seen its earnings soar with the injection of taxpayer-funded subsidies that propped up Barack Obama’s signature health program from collapse.

The nation’s largest health insurance companies have seen good business since Obamacare was first passed in 2010 and fully implemented in 2014. This has come in no small part because of federal government subsidies to the insurance industry, which government estimates show totaled $1.8 trillion in 2023 alone.

Those subsidies were greatly expanded by the Biden administration during the COVID-19 pandemic as an emergency measure, but Democrats have fought to keep them permanent.    

Obamacare brought health insurance companies historic profits

A Just the News analysis of public financial records from four of the nation’s largest health insurance companies found that net earnings ballooned about 216% from 2010 to 2024. UnitedHealth Group in particular, which dominates the industry with a market share of around 15%, saw the largest explosion of profits. The other three companies, Elevance, Centene, and Cigna also experienced a marked growth in net earnings after the implementation of Obamacare. 

The healthcare legislation was also a boon for these companies’ stock prices. One study found the weighted average of health insurance stock prices has grown 1,032% from 2010—when the law was passed—and 448% from 2013—the year the legislation’s key provisions were implemented. 

This performance far outstripped the most popular S&P 500 exchange-traded fund, which grew 251% and 139%, respectively, the Paragon Health Institute reported last year. ETFs are designed to track the performance of specific stock indices and, as such, generally represent average market growth.

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The Fraud That Won’t Die: Obamacare’s Endless Deceptions

While the government shutdown continues and health-care reform remains gridlocked, Obamacare (the Affordable Care Act) burdens taxpayers with out-of-control costs. For more than a decade, Obamacare has been riddled with systemic fraud that has been denied by Democratic Party bureaucrats, ignored by much of the media, and paid for by weary taxpayers.

Built on lies including “if you like your doctor, you can keep your doctor,” Catholics continue to bitterly recall the duplicitous role that Sr. Carol Keehan, CEO of the Catholic Healthcare Association, played in passing Obamacare—despite the pushback by the Catholic bishops because of its inclusion of abortion funding and the contraception mandate. Sr. Keehan’s mendacious shepherding of the health-care program was rewarded with a silver signing pen from President Obama.

Intensifying the pressure today on an already overburdened health-care system, the influx of several million undocumented immigrants has pushed government-funded health care to a breaking point. According to an October 2024 CBO report to Rep. Jodey Arrington, federal and state governments spent $27 billion on Emergency Medicaid for noncitizens ineligible for full Medicaid coverage between 2017 and 2023. In 2023, the estimated cost of health care for undocumented immigrants in the United States was approximately $3.8 billion, specifically for Emergency Medicaid services.

Hospitals are bound by law to provide emergency services to undocumented patients under the Emergency Medical Treatment and Labor Act (EMTALA), enacted in 1986. This is a federal law that requires hospitals to provide emergency medical care to all individuals, regardless of immigration status or ability to pay. Under EMTALA, any hospital that receives Medicare funding must conduct a medical screening exam for anyone who arrives at the emergency department and must provide stabilizing treatment for emergency medical conditions, including active labor. This mandate applies to undocumented immigrants as well as uninsured citizens and legal residents—and most of us strongly support the provision of this care to all on an emergency basis.

Unfortunately, such care is costly. According to the Trump administration, the estimated cost of emergency health care in 2024—including labor and delivery and postnatal care of the mothers and newborn babies—of undocumented immigrants in the United States rose 142 percent from the year before to an astonishing 9.1 billion dollars of taxpayer funds to pay for the emergency health care of those in the country illegally. Between 2020 to 2024, Medicaid taxpayer health-care dollars provided to illegal immigrants tripled.

Though critics argue that the Trump administration’s numbers are inflated, few challenge the fact that the nation’s hospitals are facing a fiscal crisis. In January 2024, Dr. Donna Lynne, CEO of Denver Health, publicly voiced concern over the financial strain caused by uncompensated care for undocumented individuals. Speaking at a finance and governance committee meeting, she stated, “Where do you think the migrants are getting care? They are getting care at Denver Health…It’s going to break Denver Health in a way that we didn’t even anticipate.” Her remarks highlighted the hospital system’s mounting fiscal challenges, noting that Denver Health treated over 8,000 undocumented immigrants in 2023, accounting for approximately 20,000 visits. Uncompensated care costs surged from $60 million in 2020 to $136 million in 2023.

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Behind Democrats’ Sob Stories Is A Push For More Tax Dollars To Insurance Companies

Democrats like Sen. Amy Klobuchar are framing the fight over the government shutdown and a Republican refusal to keep funding health insurance subsidies as an attack on individuals.

Poor Bill and Shelly Gall — why are congressional Republicans being so mean to them?

The story Klobuchar links to does this remarkable thing, and read this carefully:

The Galls are among roughly 22 million ACA marketplace enrollees — about 92% of all enrollees — who face the prospect of higher premiums in 2026, according to KFF, a nonpartisan health policy research group.

Democrats are pushing Republicans to extend the enhanced subsidies that make enrollees’ health premiums cheaper, as part of a deal to end the federal government shutdown that began Oct. 1. Republicans have said they want to negotiate any extension of ACA subsidies outside of legislation that would reopen the government.

See the premise? Subsidies “make enrollees’ health premiums cheaper.”

They don’t. They make enrollees’ health premiums divided, splitting the cost between the person paying for the insurance and the taxpayers who fund the subsidy, but they flatly don’t make the premiums cheaper.

It’s like you go to the supermarket and buy filet mignon, and it only costs you a dollar — wow, filet mignon is so affordable now! — but the supermarket bills the federal government for $25 every time you make that purchase, and the government gets the $25 from you as taxes. The thing costs what it costs. Subsidies don’t make it cheaper. They just hide the expense at the point of purchase. Subsidies shift and obscure.

Klobuchar claimed, “Early retirees like Bill & Shelly will see their health insurance premiums increase nearly 300%—from $442 to $1,700 per month…” But the cost of their health insurance isn’t changing at all. What’s changing is who pays for it. And if Bill and Shelly pay taxes, they’re paying, at least in part, for their own subsidies. They’re taxed so that their taxes can be transferred to them as subsidies. What a remarkable game.

But then take it one more step.

Democrats frame the subsidy as a payment to Bill and Shelly, and don’t you want poor Bill and Shelly to have nice things? But the payment doesn’t go to Bill and Shelly. It goes to health insurance companies. It’s a subsidy to industry, allowing corporations to hide the cost of their product. It’s a federal gift to private corporations.

As the subsidies die (among other political changes), health insurance companies are talking about the market headwinds that they face: “trouble in the government-funded insurance sector.” The submarine warfare masked with photos of poor Bill and Shelly is over the explosive growth of health care spending as a share of GDP, and the attempt to hide it by paying for it in less-noticed ways. Here’s the big finish from a story this week about the poor recent performance of UnitedHealthcare stock:

Still, shares of UnitedHealthcare remain down some 35% in 2025 as the company struggles with rising medical costs and reimbursement cuts. And these pressures, in turn, reflect the deepest fault lines in the U.S. system, including a population that’s aging faster than the workforce paying for it, medical inflation that outpaces wage growth, and a financial model that assumes employers, taxpayers, and patients can endlessly absorb higher costs—even as the federal government shuts down amid an affordability fight.

The financial model assumes that taxpayers can keep paying more. The fight isn’t about Bill and Shelly. The fight is about a spectacularly unaffordable health care business model that relies on the federal treasury:

The federal government subsidizes health insurance for over 150 million Americans through various programs and tax benefits. The Congressional Budget Office (CBO) reports that in 2023, those costs and subsidies added up to $1.6 trillion, net of offsetting receipts, mainly from Medicare and Medicaid. A small portion of that spending — $91 billion, or 6 percent — goes toward subsidies for health insurance purchased through marketplaces established under the ACA and related spending.

The ACA subsidies are only $91 billion a year, though, so it’s practically nothing.

See also this 2023 CBO report, which projects explosive growth in federal health care costs over the next decade.

We’re not having a debate about giving money to Bill and Shelly so they can enjoy their early retirement. We’re having a debate about how much money the federal government — meaning you, if you pay taxes — is going to give to private corporations. Congressional Democrats are servicing their corporate clients.

“Lack of transparency is a huge political advantage.”

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Health Insurance Companies Spend Big To Support California’s Partisan Redistricting Fight

In Washington, Democrats continue to keep the federal government shut down, demanding an extension of enhanced Obamacare subsidies scheduled to expire on December 31. Half a continent away, two health insurers are helping to fund a partisan campaign by one of the country’s most prominent Democrats. Coincidence?

The political donations represent but one more example of how big corporations want to feather the nest of Big Government and bankroll the leftist politicians willing to expand the same. It’s also yet another reason why Congress should let the enhanced subsidies expire as scheduled.

Big-Money Donations

A September story in the Sacramento Bee discussing money raised for and against the state’s Proposition 50 ballot measure on congressional redistricting noted two sizable donations from health insurers — $500,000 from Blue Shield of California, and $75,000 from UnitedHealth, the nation’s largest insurer. The news raises numerous questions, starting with how the insurers could afford such large political contributions in the first place.

After all, as I have previously noted, a recent California law that went into effect in March requires insurers to engage in “cultural competency training” regarding the transgender agenda. Apart from the fact that such training — more like indoctrination — likely violates employees’ First Amendment rights and federal conscience protections, it could also prove costly for insurers.

On top of the new administrative costs from this new mandate, UnitedHealth faces expenses from last year’s hack of Change Healthcare, one of its affiliates, that caused chaos within the health care system for months. So where and how exactly did these insurers have the wherewithal to make such large contributions?

Partisan Affair

The related question focuses more on the specifics of Proposition 50 itself. The referendum doesn’t touch on a health care-related issue — or really any policy issue whatsoever. It’s a pure political power play by Gov. Gavin Newsom, D-CA, attempting to gerrymander more Democratic-leaning congressional districts in California to offset Republican gerrymanders in Texas and elsewhere. Why are health insurers getting involved in such overtly political activities?

In responding to questions from the Daily Wire, Blue Shield of California claimed that it made its donations to Newsom’s ballot measure committee before it knew that Proposition 50 would end up on the November ballot. That’s arguably true regarding its first $250,000 contribution, made on April 24. But by the time of its second $250,000 contribution on July 16, rumors had started swirling about actions by California to respond to redistricting efforts by Texas Republicans.

Blue Shield of California also told the Daily Wire that it contributes to lawmakers on a bipartisan basis. But after its $500,000 contribution to Newsom’s ballot measure campaign, its next-largest contributions were $50,000 to the California Democratic Party, and $20,000 to the LGBT Caucus Leadership Fund — all of which suggests its donations go overwhelmingly to Democrats in a state with de facto one-party rule.

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Protest as 200-year-old oak trees face chop to save house built in 1980s… with villagers accusing insurance giant of ‘eco-terrorism’

Planted in George III’s reign, the three oaks have stood side by side for more than two centuries.

But now two of the trio – known as the Billingshurst Sisters – could be felled over claims they have damaged a nearby house built in the 1980s.

Insurance giant AXA said their roots have caused cracks and subsidence in the home in the West Sussex village and that the 90ft-high trees must be axed.

The firm has overturned a Tree Preservation Order (TPO) and has sought permission to chop them down from the landowner, Billingshurst Parish Council.

However, furious villagers branded the move ‘eco-terrorism’ and urged the council to oppose the application. Their fate will be decided at a meeting tomorrow.

Campaigners accuse AXA of using a sledgehammer to crack a nut – and failing to properly investigate the subsidence.

They say that shallow foundations or other factors may instead be to blame. More than 2,500 villagers have now signed a petition to save the oaks.

Gabi Barrett, who launched the petition, said the trees are ‘vital to the community’s ecosystem’.

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Politico Is Doing Insurance Companies’ Bidding, And It’s Obvious Why

n February, I analyzed how Politico functions as a glorified patronage racket, whereby “reporters serve as a publicity rag for K Street and get paid handsomely for doing so.” Six months later, another such article serves as Example No. 8,579 (or thereabouts) of this swamp machine in action.

In this particular case, Politico published an advertisement — I mean, article — about a potential extension of Obamacare’s enhanced insurance subsidies, which expire at the end of the year. That story ignored sizable evidence of fraud associated with the subsidies, while including not a single quote from a critic or skeptic of such an extension. It looks like a not-too-subtle attempt from Politico to cheerlead for the insurance industry — i.e., its corporate subscribers.

Big Signs of Fraud

The article focused largely on Florida and highlighted that state’s sizable enrollment in Exchange coverage, particularly for households claiming very low incomes, which qualify for the biggest subsidies: 

Florida is one of 10 states that have not expanded Medicaid, so it’s more difficult for some low-income residents to qualify for the government health insurance program. The enhanced subsidies ensure that people who would be eligible under an expansion — those making just above the federal poverty level, with incomes between about $15,600 and $21,600 — can get Obamacare coverage, typically with no premiums. Two-thirds of the 4.6 million Floridians on Obamacare plans are in this gap…

But there’s one big fact Politico omitted: According to one study, while there are nearly 3.1 million Obamacare enrollees claiming income just above poverty in Florida, estimates derived from the Census Bureau suggest that only about 630,000 households actually have incomes in that range. (Disclosure: While I have done work for the Paragon Health Institute, which published the study in question, I had no involvement with this particular report and am writing this article on my own behalf.)

In other words, by one organization’s estimate, more than 2.4 million enrollees — over half of Florida’s total Exchange enrollment — are potentially fraudulent. These individuals may have overstated their income because households with income below the poverty level don’t qualify for subsidies at all, or conversely, they may have understated their income if they make two or three times the poverty level, so they can qualify for bigger subsidies. Alternatively, people could have been enrolled in “free” coverage without their knowledge by insurance brokers seeking commissions, an offense one Florida-based insurance executive pleaded guilty to this April.

Yet Politico mentioned none of this. It advertised the total enrollment in the Florida Exchange, and the billions of dollars in enhanced subsidies that went to Florida, without noting either the significant questions about enrollment discrepancies in Florida’s Exchange population or the fraud — totaling $133.9 million, according to the Justice Department — that one Florida-based individual has already admitted to.

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DOJ questions ex-UnitedHealth doctors in probe into Medicare fraud: report

The Department of Justice questioned former UnitedHealth doctors as it investigates claims that the health insurance giant pushed staffers to make diagnoses that triggered higher Medicare payments, according to a report Wednesday.

The investigation, which dates back to at least last summer, concerns alleged efforts to encourage staffers to record certain diagnoses that trigger higher payments under Medicare Advantage, the program for seniors and the disabled, the Wall Street Journal reported.

Investigators for the Justice Department, FBI, and Health and Human Services Department have been asking for details on patient testing, procedures used to reach certain diagnoses and the process of sending nurses to patients’ homes, according to former UnitedHealth employees.

The Department of Justice did not immediately respond to The Post’s request for comment.

UnitedHealth, whose healthcare executive Brian Thompson was executed by an assassin last year outside a Midtown hotel, said it stands “firmly behind the integrity of our Medicare Advantage business.”

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ICE Is Snooping on Your Medical Bills

The feds are vacuuming up a lot of data on Americans in the name of stopping illegal immigration. Their latest target? Your insurance data.

Immigration and Customs Enforcement (ICE) is now using data from the Insurance Services Office’s ClaimSearch, a private industry service for detecting car and health insurance fraud, according to ICE documents obtained by the tech news site 404 Media on Wednesday. ClaimSearch includes 1.8 billion insurance claims and 58 million medical bills—along with the personal data attached to them, including addresses, tax identification numbers, and license plates.

ClaimSearch’s public policy states that it grants full access to law enforcement agencies “investigating or prosecuting insurance-related crime, or developing background information about a specific individual or list of individuals who have been identified as persons of interest with regard to homeland security activity.”

Verisk, the company that runs ClaimSearch, denied to 404 Media that ICE or the Department of Homeland Security is one of its clients. But the National Insurance Crime Bureau, which controls access to ClaimSearch, did not directly answer whether ICE has access. 404 Media speculated that ICE could have gained access through another government agency.

In March 2025, the Trump administration signed an executive order to tear down “information silos” between federal agencies, and in May, the IRS signed a data-sharing agreement with ICE. The administration has leaned heavily on surveillance contractor Palantir, which has a contract with ICE to facilitate “complete target analysis of known populations.”

ICE has also been tapping into the nationwide network of license plate reading cameras by asking local law enforcement agencies to run searches for specific cars, 404 Media reported earlier this year. Some police departments insisted to 404 Media that the searches were conducted for ICE’s Homeland Security Investigations branch, which handles organized crime and smuggling rather than immigration enforcement.

However, the ICE documents on ClaimSearch specifically said that the data was going to Enforcement and Removal Operations, the branch that handles the detention and deportation of undocumented immigrants.

The immigration cops didn’t just start building their mass surveillance dragnets this year. In 2021, at the start of the Biden administration, The Washington Post reported that ICE was buying utility company records. While Customs and Border Protection (CBP) insisted in a 2018 report that it buys “only anonymized data” from third-party brokers, it has used commercial cell phone data to track and arrest specific people.

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RFK Jr. Announces “Health Insurance Breakthrough” That Affects Nearly 260 Million Americans

In a press conference on Monday, HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz announced a landmark agreement with the nation’s largest health insurers to tackle the number one healthcare problem plaguing hundreds of millions of Americans: prior authorization.

Prior authorization is the requirement for doctors and patients to get advance approval from insurance companies BEFORE certain treatments, tests, or procedures are covered. It was meant to control costs, but for 85% of Americans, it’s become a serious barrier to care.

“Doctors like myself are continually struggling with this issue,” Dr. Oz said, explaining how the bureaucratic process not only delays treatment but deeply frustrates both providers and patients.

In 2023 alone, Medicare Advantage (which covers about 32 million people) initially denied 3.2 million prior authorization requests. Dr. Oz made clear these are not just numbers: they represent “individuals who often, in the most vulnerable time in their lives, needed something done and it was denied.”

The burden also falls heavily on physicians. On average, doctors spend 12 hours per week on paperwork, handling about 40 prior authorization cases weekly. Dr. Oz said it contributes to burnout, slows down care, and “erodes public trust in the health care system.”

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UnitedHealth Shares Drop After Report Alleges Secret Bonus Payments To Nursing Homes For Cutting Hospital Transfers

UnitedHealth Group shares dropped as much as 7.5% in premarket trading Wednesday in New York, following a Guardian investigation that revealed the health insurer shelled out “Premium Dividend” and “Shared Savings” bonuses to nursing homes that reduced hospital transfers for sick residents. 

The Guardian’s investigation is based on thousands of confidential corporate and patient records obtained through sources, public records requests, and court filings, along with interviews with nearly two dozen current and former UnitedHealth and nursing home employees, as well as two whistleblower declarations submitted to Congress.

The report offers a new snapshot into UnitedHealth’s daily operations at nearly 2,000 nursing homes across the country, where it manages Medicare Advantage coverage for more than 55,000 long-term residents. 

Here are some of the key findings from the report:

  • UnitedHealth stationed in-house medical teams at nearly 2,000 nursing homes, incentivizing them to lower hospitalizations through financial rewards like “Premium Dividend” and “Shared Savings” payments tied to hospitalization rates.
  • Internal records show UnitedHealth monitored nursing homes using “admits per thousand (APK)” metrics and set “budgets” for hospitalizations. Facilities with high APKs were denied bonuses.
  • In multiple documented cases, patients were denied urgent hospital care, leading to serious harm, including permanent brain damage. Whistleblowers say these incidents were hidden or minimized.
  • Nurse practitioners were pressured to push “Do Not Resuscitate” (DNR) orders, even when patients had previously expressed the desire for life-saving treatments.
  • UnitedHealth also incentivized increased enrollment in its Institutional Special Needs Plans by offering large payments to nursing homes, which in some cases leaked confidential patient data to help sales teams directly solicit families—often bypassing consent rules.

The Guardian noted: 

In several cases identified by the Guardian, nursing home residents who needed immediate hospital care under the program failed to receive it, after interventions from UnitedHealth staffers. At least one lived with permanent brain damage following his delayed transfer, according to a confidential nursing home incident log, recordings and photo evidence.

A current UnitedHealth nurse practitioner, who recently submitted a congressional complaint regarding the nursing home program, stated:

“No one is truly investigating when a patient suffers harm. Absolutely no one.

“These incidents are hidden, downplayed and minimized. The sense is: ‘Well, they’re medically frail, and no one lives for ever.'”

A former national UnitedHealth executive said:

“APK drove everything. You gain profitability by denying care, and when profitability suffers for the shareholders, that’s when people get crazy and do things that are not appropriate.”

Two current and three former UnitedHealth nurse practitioners said that UnitedHealth managers pressured them to persuade Medicare Advantage members to change their “code status” to DNR, even when patients had clearly expressed a desire to receive all available life-saving treatments.

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